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Objective This study was designed to validate the utility of a population pharmacokinetic model established for vancomycin in patients with severe neurosurgical disease . Methods The clinical data including patient gender , age , body weight ,serum creatinine and albumin were collected retrospectively from patients in Nanjing Drum Tower Hospital to calculate the steady trough concentration of vancomycin using the previously established pharmacokinetic model .The predicted value was compared with the actual value .Results During the period from March 2013 to March 2014 ,53 blood samples with serum trough concentration of vancomycin were collected from 42 patients .The average trough concentration of vancomycin was 10 .9 mg/L (range from 1 .6 to 49 .1 mg/L) .The predicted trough level of vancomycin based on the population pharmacokinetic model was significantly correlated to the actual value(r=0 .857 ,P<0 .001) .The mean absolute percentage error was 0 .407 9 . The confidence interval was 9 .36‐14 .07 for the predicted values ,and 8 .92‐14 .32 for the actual values .Conclusions The pharmacokinetic model is valid and useful for planning intravenous dose of vancomycin in patients with severe neurosurgical disease .Large error (about 30% ) was observed in estimation of body weight due to coma .Reduced renal function following contrast agent and/or diuretic drug has an impact on the predicted results . The accuracy of prediction can be increased to nearly 70% after adjusting the covariates .
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Objective:To evaluate the effects of losartan、fosinopril and captopril on the excretion rate of urinary albumin (UAER) and the clearance of endogenous creatinine (Cr-C) in elderly patients. Methods:In this study,162 elderly patients with stage of the 2—3 class hypertension were included,The patients were divided into 3 groups,that were losartan group and the fosinopril group and captopril group,the anti-hypertensive effects and UAER and Cr-C were determined before and after the treatment. Results:The hypertensive effect rates were 94% in losartan group and 93%、93% in fosinopril group and captopril group respectively.Decrease of UAER was observed in 89% of patient in losartan group and 59%、50% in fosinopril group、captopril group.Cr-C were improved in 94%、78% of patient in losartan group and in fosinopril group and 63% in captopril group. Conclusions:Losartan has better effects on UAER and Cr-C than captopril in elderly hypertensive patients.
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OBJECTIVE:To carry out the cost-effectiveness analysis of treating child bronchopneumonia with cefazolin,cefatrizine,cefataxime and cefuroxime METHODS:Using retrospective study and cost-effectiveness analysis,the costs of tre_atment of children with bronchopneumonia were calculated and pharmacoeconomically evaluated RESULTS:The costs of cefazolin,cefatrizine,cefuroxime and cefataxime in treatment of child bronchopneumonia were RMB 512 84,725 42,796 28 and 734 16 yuan and the cost-effectiveness ratios were 93 68,475 83,517 30 and 412 28 respectively CONCLUSION:In comparison with cefatrizine,cefuroxime and cefataxime,cefazolin is the most inexpensive one However,in evaluating the therapeutic cost of a drug, we should consider its therapeutic efficacy and course